What do you consider an Accident?

An unplanned or unforeseen event resulting in bodily injury that requires immediate medical treatment in a hospital.

What is the waiting period?

There is a 1 day waiting period before you may be eligible for treatment under Accident Override, for Accidents that occur after you join a hospital product with Accident Override included.

What if I have an accident outside of Australia?

There are no restrictions related to Accidents that happen outside of Australia, provided all other eligibility requirements are met, Accident Override may be applied for any treatment received within Australia. Any treatment provided outside Australia would not be paid for by ahm.

What if I need continued care after my initial hospitalisation?

If ahm paid towards your initial hospital treatment under Accident Override, we may also help with costs for any ongoing hospital treatment that's part of the same course of care.

When else might Accident Override not apply?

If the Accident happened prior to joining ahm, Accident Override would not apply for the required treatment. Additionally, in cases where the initial medical treatment was not claimed under Accident Override, any follow-up or ongoing treatment cannot be claimed under Accident Override.

Accident Override explained

With Accident Override, ahm may cover hospital treatments that are usually Restricted or Excluded under your cover, if they’re a result of an Accident. If you're eligible, we’ll help with the costs so you can get back on your feet (literally).

Important to know about Accident Override:

Product eligibility

Accident Override is only available on some ahm hospital covers. To check if the cover you’re interested in or already hold includes this feature, please refer to the product guides or the individual product pages on our site.

What's included with Accident Override

Benefits may be payable for the initial hospital treatment for injuries resulting from an Accident, provided the Accident happened after joining or upgrading on an eligible ahm hospital cover.

If the treatment is an ‘Excluded or Restricted Service’, a member can apply for Accident Override, where you will receive the same benefits as though it was an Included service on your cover.

We’ll also cover for ongoing hospital treatment when ahm has paid benefits for the initial hospital treatment under Accident Override (subject to clinical approval for subsequent treatment).

Claim process

To make a claim under Accident Override, you’ll need to submit an Accident claim form for assessment (available on our member portal).

Find hospital cover that suits your needs

Basic

ambulance & accident hospital (basic)

Accident Override that also overrides the excess - say no more.

View cover

Basic plus

core hospital (basic+)

Handy inclusions like sleep studies, dental surgery and joint reconstructions, and no excess for dependants - nice.

View cover

Bronze plus

core bronze plus

The full bronze and more - our best in class.

View cover

See more hospital products

*Price is for single cover in NSW paying weekly by direct debit. Price reduced by an Australian Government Rebate of 24.118% (based on an age of under 65 years old, single income of $101,000 or less per year). Hospital price includes an excess of $750, excludes any Youth Discount and excludes Lifetime Health Cover loading. Heads up, the income thresholds used to calculate the Australian Government Rebate (AGR) and Medicare Levy Surcharge (MLS) are changing from 1 July 2026, so your entitlement to the AGR may change after that date. More on the AGR & MLS changes and how this may affect you

Billboard stating "Got questions? We've got the answers"

Common questions

Compare your options

We’ve got lots of different types of hospital cover, find one that suits you.

Compare hospital covers

Get the most out of private hospital cover

Wherever you’re at in life, we’ll help you get the most from your ahm health insurance hospital cover.

Tell me more about hospital cover